This invention is directed towards an apparatus and process for removing coins or similarly-shaped obstructing objects from the upper esophageal region.
Esophageal obstructions by swallowed coins are a frequent occurrence in younger children. Although most ingested coins will pass spontaneously through the intestinal tract, if too large to clear the cricopharyngeal ring, they become impacted in that area. However, there is still much debate as to the best approaches for the removal of such objects. A variety of medical procedures and techniques have been developed for the removal of coins and similarly shaped objects from the upper esophagus.
For instance, endoscopic surgery, employing rigid esophagoscopy, is often selected as a technique for the removal of a coin. Such a procedure has the advantages of offering a clear visualization of the obstructing foreign body and provides a firm engagement and controlled removal of the foreign object. However, endoscopic removal entails the costs of hospital admission and operating room use, costs and risks of general anesthesia, as well as attendant emotional stress on the child""s care givers. Likewise, flexible endoscopy or direct laryngoscopy advocated by some practitioners have similar costs and concerns. For coin-like objects which are neither impacted within the esophagus nor irregularly shaped, less invasive and costly procedures are often adopted.
A second approach advocated by some practitioners is the dislodgement of esophageal coins using a Foley balloon catheter. The catheter is inserted through the oral cavity and past the obstruction, followed by the inflation of the balloon. Upon withdrawal of the inflated catheter, the obstructing object is forced upwardly into the oral cavity from where it needs to be expelled or removed. However, the procedure exerts no control over the coin as it passes in proximity to the oropharynx and raises concerns about possible damage to the esophagus, dislodgement into the nasopharynx, or obstruction of the airway.
A third less commonly used alternative is Bougienage displacement, advocated by some, in which a tube-like esophageal dilator is inserted through the esophagus forcing the coin/obstruction downstream and into the stomach. While the coin will thereafter usually pass through the gastrointestinal tract in a subsequent stool, parents are often concerned that the obstructing object is not immediately removed. Further, the bougienage technique is not without some risk of damaging the esophagus.
Accordingly, there remains room for improvement and variation within the art of removal of coins and similar objects which obstruct the upper esophageal region.
It is an object of the present invention to provide an apparatus and method which affords a rapid and safe removal of a coin from the esophagus of a patient.
It is yet another object of the present invention to provide a removal apparatus which facilitates removal of a coin-like obstructing object from the esophagus of a patient without sedation or anesthesia.
It is still a further object of the present invention to provide a grasping forceps and method which provides a strong, firm grasp of a coin-like obstruction lodged within the esophagus of a patient.
It is still a further object of the present invention to provide a grasping forceps suitable for removing an obstructing object from the esophagus, in which the forceps is surrounded by a flexible hollow sheath which protects the pharyngeal and esophageal tissue guiding the forceps to a proper position within the esophagus directly to the obstructing coin or coin-shaped object.
It is still a further and more particular object of the invention to provide a coin removal tool which is radiopaque.
It is still a further and more particular object of the invention to provide a sterilized kit comprising the necessary and assembled components needed for the fluoroscopic assisted removal of a coin or similar obstructing object from the esophagus of an unsedated patient.
These and other features, aspects, and advantages of the present invention will become better understood with reference to the following description and appended claims.